Saturday, August 07, 2010

The one thing I must have to be truly alive

The other week I listened to Atul Gawande on NPR's Fresh Air. He was talking about a recent article he wrote for The New Yorker about what medicine and doctors should and shouldn't do to make the end of life more humane. It was fascinating stuff. I mostly know of Atul Gawande from his book Complications: A Surgeon's Notes on an Imperfect Science, which I touched many times in my Borders days, but this is the first time I've listened to him talk.

In the Fresh Air interview, he talked about how taking lots of drugs and having lots of medical intervention when one is old and/or terminally ill often do nothing to prolong life any longer than a non-drugged hospice route. He also talked about how hard it can be when it falls to family members to make end-of-life decisions, especially when the patient's wishes are unclear. He gave an example of one son or daughter - I think it was a daughter? - who asked her father what was his minimum quality of life for which he would actually want to be saved. The man said that as long as he could still eat ice cream and watch football on TV, that would be sufficient for him and he'd still want to be alive.

Atul Gawande pointed out that this ice-cream-and-football life may not be enough for some people. They might insist that they be able to walk around, or cook for themselves. This made me think about my minimum standard. I mean, I generally want to be able to travel, and go out, and write and run and swim and hike and explore. Sure - these are all things I want from my life. But if it came to that kind of decision about the minimum acceptable quality of life? The answer was instantly clear to me: as long as I could still read books, I would still want to be alive.

Note that this does NOT mean being read to. I hate being read to. No books on tape, and I would obviously have to be able to see, and be able to hold a book. But that is my answer. Reading. What's yours?


Chad Rector said...

My standards might change over time. I can imagine how ten years ago I might have said that it would not be worth living if I had chronic pain that made it hard for me to move around or sit in one position for a couple hours. But now that my shoulder hurts all the time, I have decided that I would prefer not to be euthanized just yet thanks.

Anonymous said...

Linda's grandma Nap wanted to stay in her house until the end. She wanted her independence. She was lonely without her husband who died before her. But even when he was living, she wanted her life, she did not want to end up in an assisted care facility, much less an invalid in a nursing home. Her philosopy, she had a good life, why not go when your time is ready? She pretty much made it. When she was relegated to a full care facility after a series of strokes and riddled with cancer, and realized she wasn't going to be able to knit, which she so loved to do, or take care of herself, she decided that she'd had enough. She quit her pills and didn't eat much, lost the will to live, and went quickly to join her husband in the next life. I think that I will be ready when I no longer can be functional. Why prolong it?